Peripheral retinal retinal degeneration treatment. Peripheral pvhrd retinal dystrophy

1120 08/02/2019 4 minutes

Peripheral dystrophy retina is one of the rare, but rather dangerous diseases... When an ailment appears, the absence of timely medical care can lead to disastrous consequences, however correct treatment help preserve vision. In addition, the problem can be difficult to diagnose and usually takes a long time to analyze.

Definition of disease

Peripheral retinal dystrophy is usually understood as an eye disease (most often of a hereditary nature), the development of which is accompanied by tissue destruction processes with subsequent deterioration of vision. In advanced stages, a complete loss of vision is likely without the possibility of recovery (the same outcome is possible with prolonged ignoring).

According to official statistics, up to forty percent of people with farsightedness and up to eight percent suffer from myopia.

People with diseases of the organs of vision are recommended prevention and periodic examination for the possibility of acquiring retinal dystrophy.

The following forms of the disease are distinguished:

• Lattice. It is characterized by the appearance of white stripes, deterioration of blood circulation in blood vessels eyes and cyst formation. Often occurs against the background of retinal detachment.
• Retinoschisis. It is characterized by retinal stratification, most often observed with the development of myopia. In most cases, it is hereditary.
• Frostlike. It is characterized by the appearance of frost-like white inclusions on the anterior surface of the eye. It is inherited.
• With changes in the form of a snail trail. When a disease occurs, the appearance of perforated pathologies resembling a snail track is observed. Often accompanied by tissue tears.
• Altered in the form of a cobblestone pavement. With the disease, pathologies are observed in the form of oblong rings, it is possible to separate pieces of pigment. Often diagnosed with myopia.
• Small cystic. It is characterized by the appearance of a large number of small red cysts.

Causes of occurrence

The disease can occur in people of any age and category. Among the most frequent reasons its occurrence is distinguished:

• Heredity (if relatives suffered from this type of problem);
• Traumatic brain injury, eye damage;
• (less often - myopia);
• Injuries associated with excessive physical exertion;
• Diabetes;
• Atherosclerosis;
• Cardiovascular diseases;
• Chronic diseases;
• Diabetes;
• Violation of the blood supply to the organs of vision;
• Intoxication of the body.

Accumulated waste products in the body can also cause the problem. Rarely, the disease develops during pregnancy.

Symptoms

In the early stages of the disease, most often there are no signs of its development. Most of the symptoms (with the exception of those visible) are the same for each type of retinal dystrophy:

• (not always symmetrical);
• Veil, fog before the eyes;
• Wrong perception of the forms of objects of the surrounding reality;
• Fast fatiguability, constant fatigue eye.

Sometimes symptoms can occur simultaneously, or they can occur separately or in turn.

In the event of abnormal fatigue of the organs of vision, it is recommended to contact an ophthalmologist for diagnostics for the development of retinal dystrophy.

Possible complications

In the case of a timely diagnosis of the disease, its progression is stopped with the help of treatment. The quality of the results of the intervention depends on the stage of development of dystrophy. In the absence of proper treatment, destruction of important tissues of the eye is possible, complete or partial loss of vision (as it happens during which we will consider next time) without the possibility of recovery. Retinal detachment is also possible.

Treatment

Currently, there are several techniques. Their choice depends on the type and stage of the problem.

Medication

Treatment of the disease with medicines gives positive results only on early stages and in case of combination with other methods. Among the main drugs for procedures are:

• Vasoconstrictor;
• Angioprotectors;
• Means for strengthening blood vessels;
• Vitamin complexes.

Surgically

Usually, surgical operations are shown to improve blood supply and metabolism. However, the following procedures are most often carried out: Traditional methods help prevent irreversible consequences the course of peripheral dystrophy and improve the condition of the organs of vision in general. However, it is recommended to use them only after consulting an ophthalmologist and as an adjunct to medical methods.

As such additional funds use infusion of Japanese Sophora. Five grams of Sophora are mixed with half a liter of vodka and infused for three months. Apply the product one teaspoon three times a day, after mixing with a small amount of water.

Prevention

The main preventive method for peripheral retinal dystrophy is periodic examination by an ophthalmologist. Those who have vision problems and frequent illnesses organs of vision, constant observation by a doctor is especially important. Also useful healthy image life, immunity support and the adoption of vitamin complexes.

Video

findings

Peripheral is a rare disease that is dangerous to health and vision. It is difficult to diagnose and does not always respond to full recovery. However, its development can be easily prevented by asking for medical help with the appearance of the first symptoms, and the development should be stopped, thereby increasing the chances of maintaining vision.

Dystrophic processes of the structures of the eye most often develop in the peripheral zones of the retina. Scientific language calls them peripheral retinal degenerations.

Such processes are dangerous for the eye both by their consequences and by late diagnosis due to the peculiarities of the eye structure.

What Happens in Peripheral Retinal Degeneration?

With dystrophic changes, areas of the retina gradually become thinner. Tension zones are formed between vitreous and the retina, as a result of which it is torn in some places. Through this gap, the fluid components of the vitreous pass under the retina, which lift the retina and detach it.

So, as a result of degenerative processes, retinal detachment occurs - the most formidable eye disease, which, moreover, does not immediately make itself felt by the manifestation of symptoms. Another problem with peripheral degeneration is the location of the pathological process zone. It is located behind the "equator" of the eye, so it can be difficult to see during a normal ophthalmological examination.

Why is it developing?

This pathology occurs in humans different ages, in children, including. Some vascular, inflammatory and other changes in the structures of the eye lead to retinal degeneration. It is very often observed in nearsighted people... In this case degenerative changes occur due to lengthening of the eyeball. The main reason for dystrophic changes is a hereditary predisposition.

Also among the reasons:

Common diseases:

• atherosclerosis,
• hypertonic disease,
• diabetes,
• infections,
• intoxication.

Views

Lattice degeneration, in which the dystrophic process is clearly localized. Varieties: snail track, when degeneration occurs in the form of a white stripe, palisade - dystrophy zones are defined as white streaks. In the problem area, fusion with the vitreous occurs. Lattice degeneration is more often bilateral.

• Microcystic degeneration appears as a mass of red dots against a white-gray background. Localization of the lesion at the dentate line. This type of degeneration is also more likely to be bilateral and is more common in people over 40.
• Degeneration of the "cobblestone" appearance leads to the formation of white, depigmented lesions. This type of pathology rarely leads to retinal detachment, that is, it is the most benign in its consequences.

Diagnostics and treatment

The primary diagnosis is made by the ophthalmologist of the polyclinic. To do this, you need to conduct an ophthalmological examination, which includes:

• Perimetry,
• Visometry,
• Ophthalmoscopy with a Goldmann lens or scleral depression.

Necessarily appointed laboratory research blood and urine.

Treatment is carried out in an ophthalmic hospital. It can be surgical and laser. Moreover, every year it is laser technologies that are becoming more widespread, since they allow therapeutic measures as quickly and accurately as possible.

Mandatory treatment is prescribed for lattice degeneration. Cystic and “cobblestone” type degeneration require treatment when the patient complains of photopsia, when myopia progresses and reveals significant retinal detachment, in the presence of blindness in the eye affected by peripheral dystrophy. In other cases, recommendations for maintaining eye health and regular monitoring of the condition of the retina are given.

Most often, prophylactic laser coagulation is performed for treatment. With its help, areas of dystrophy and healthy eye tissues are distinguished, a new line of attachment of the retina and fundus is created. As a result, the risk of its detachment is significantly reduced, which means that the patient's vision is preserved. The success of treatment directly depends on the timing of receiving the help of a specialist.

Such processes are dangerous for the eye both by their consequences and by late diagnosis due to the peculiarities of the eye structure.

What Happens in Peripheral Retinal Degeneration?

With dystrophic changes, areas of the retina gradually become thinner. Zones of tension are formed between the vitreous body and the retina, as a result of which it breaks in some places. Through this gap, the fluid components of the vitreous pass under the retina, which lift the retina and detach it.

So, as a result of degenerative processes, retinal detachment occurs - the most formidable eye disease, which, moreover, does not immediately make itself felt by the manifestation of symptoms. Another problem with peripheral degeneration is the location of the pathological process zone. It is located behind the "equator" of the eye, so it can be difficult to see during a normal ophthalmological examination.

Why is it developing?

This pathology occurs in people of different ages, including children. Some vascular, inflammatory and other changes in the structures of the eye lead to retinal degeneration. Very often it is observed in people with nearsightedness. In this case, degenerative changes occur due to lengthening of the eyeball. The main reason for dystrophic changes is a hereditary predisposition.

Also among the reasons:

• Myopia,
• Inflammatory eye diseases
• Vascular diseases of the eyes,
• Injuries

Common diseases:

• atherosclerosis,
• hypertonic disease,
• diabetes,
• infections,
• intoxication.

Lattice degeneration, in which the dystrophic process is clearly localized. Varieties: snail track, when degeneration occurs in the form of a white stripe, palisade - dystrophy zones are defined as white streaks. In the problem area, fusion with the vitreous occurs. Lattice degeneration is more often bilateral.

• Microcystic degeneration appears as a mass of red dots against a white-gray background. Localization of the lesion at the dentate line. This type of degeneration is also more likely to be bilateral and is more common in people over 40.
• Degeneration of the "cobblestone" appearance leads to the formation of white, depigmented lesions. This type of pathology rarely leads to retinal detachment, that is, it is the most benign in its consequences.

Diagnostics and treatment

The primary diagnosis is made by the ophthalmologist of the polyclinic. To do this, you need to conduct an ophthalmological examination, which includes:

• Perimetry,
• Visometry,
• Ophthalmoscopy with a Goldmann lens or scleral depression.

Laboratory tests of blood and urine are mandatory.

Treatment is carried out in an ophthalmic hospital. It can be surgical and laser. Moreover, every year, it is laser technologies that are becoming more and more widespread, since they allow carrying out medical measures as quickly and accurately as possible.

Mandatory treatment is prescribed for lattice degeneration. Cystic and “cobblestone” type degeneration require treatment when the patient complains of photopsia, when myopia progresses and reveals significant retinal detachment, in the presence of blindness in the eye affected by peripheral dystrophy. In other cases, recommendations for maintaining eye health and regular monitoring of the condition of the retina are given.

Most often, prophylactic laser coagulation is performed for treatment. With its help, areas of dystrophy and healthy eye tissues are distinguished, a new line of attachment of the retina and fundus is created. As a result, the risk of its detachment is significantly reduced, which means that the patient's vision is preserved. The success of treatment directly depends on the timing of receiving the help of a specialist.

TvoyAybolit.ru

Peripheral retinal dystrophy is an extensive group of ophthalmic diseases, which are characterized by progressive damage to the retina. In ophthalmology, they are also called peripheral vitreochorioretinal dystrophies. All PVCRDs lead to the gradual destruction of rods - photosensitive photoreceptors responsible for visual perception.

In people with retinal dystrophy, peripheral vision and dark adaptation are impaired. This means that they have poor vision in dark rooms and have difficulty distinguishing objects located to the side of them. With the development of complications in patients, more obvious and dangerous symptoms may appear.

Views

Depending on the nature of the pathological changes in the retina, several types of peripheral degeneration are distinguished. Only an ophthalmologist can distinguish them after an ophthalmoscopy - examination of the fundus. During the examination, the doctor may see the retina that lines eyeball from the inside.

Lattice

It occurs in about 65% of cases and has the most unfavorable prognosis. According to statistics, it is lattice dystrophy that most often leads to retinal detachment and loss of vision. Fortunately, the disease is sluggish and progresses slowly throughout life.

Lattice degeneration is characterized by the appearance of narrow white stripes on the fundus, which outwardly resemble a lattice. They are desolate and hyaline-filled vessels of the retina. Between the white cords, areas of the thinned retina are visible, which have a pinkish or red tint.

By the type of snail track

This type of peripheral retinal degeneration most often develops in people with high degrees of myopia. Pathology is characterized by the appearance on the retina of a kind of perforated defects that outwardly resemble a snail's track on the asphalt. The disease leads to tears of the retina with its subsequent detachment. Read more about retinal rupture →

Frostlike

It is a hereditary disease that affects men and women. Frost-like peripheral dystrophy is characterized by the appearance of whitish deposits on the retina of the eye, outwardly resembling snow flakes.

Cobblestone type

It belongs to the least dangerous retinal PVCRD. It occurs more often in the elderly and people with myopia. The disease is almost asymptomatic and has a relatively favorable course. It rarely leads to tears or detachments of the retina.

With cobblestone dystrophy, multiple foci of degeneration are visible on the fundus. They are white, elongated and uneven. As a rule, all lesions are located in a circle, at the very periphery of the fundus.

Retinoschisis

The disease is hereditary. It leads to the detachment of the retina and the formation of huge cysts filled with fluid. Retinoschisis has an asymptomatic course. In some cases, it is accompanied by local loss of vision at the site of the cyst. But since the pathological foci are in the periphery, this goes unnoticed.

Small cystic

The pathology is also called Blessin-Ivanov disease. Small cystic PCRD of the retina is accompanied by the formation of many small cysts on the periphery of the fundus. Usually the disease has a slow course and a favorable prognosis. However, in rare cases, cysts can rupture, resulting in ruptures and detachments of the retina.

Causes

A considerable part of peripheral chorioretinal dystrophies of the retina are hereditary diseases. In 30-40% of cases, the development of the disease provokes high degrees of myopia, in 8% - hyperopia. Damage to the retina can also result from systemic or ophthalmic diseases.

Possible reasons development of peripheral degenerations:

• hereditary predisposition, the presence of PFRD in close relatives;
• myopia (myopia) of any degree;
• inflammatory diseases eye (endophthalmitis, iridocyclitis, etc.);
• suffered injuries and surgical interventions;
• diabetes mellitus and other diseases of the endocrine system;
• intoxication and viral infections;
• atherosclerosis and diseases of the cardiovascular system;
• frequent and prolonged sun exposure without sunglasses;
• lack of vitamins and minerals that are necessary for the normal functioning of the retina.

In young people, acquired retinal degeneration most often develops against the background of high myopia. In the elderly, pathology occurs due to a violation of the normal blood circulation and metabolism in the tissues of the eyeball.

Symptoms

At first, peripheral retinal dystrophy does not appear in any way. Occasionally, it can make itself felt with bright flashes or flashing flies before the eyes. If a patient has impaired peripheral vision, he does not notice it for a long time. As the disease progresses, the person realizes that he needs a brighter light when reading. Over time, he may develop other visual impairments.

Most frequent symptoms PVCRD:

• Narrowing of visual fields. The patient poorly sees objects located on the periphery. To see them, he has to turn his head. In the most severe cases, people develop what is called tunnel vision.
• Appearance by livestock. Defects in the field of view can be invisible or appear as black or colored spots. In the first case, they can be identified using additional research methods - perimetry and campimetry.
• Niktalopia.Peripheral retinal degeneration of the eye leads to damage to the rods, the light-sensitive elements responsible for night vision. For this reason, pathology is often accompanied by night blindness ( poor eyesight at dusk).
• Metamorphopsia. The symptom is manifested by distortion of the contours and sizes of visible objects.
• Blurred vision. A person may think that he is looking at the world through fog or a thick layer of water.

When complications appear (rupture or detachment of the retina), the patient has sparks, lightning, bright flashes before the eyes. In the future, a dark curtain forms in the field of view, preventing normal vision. These symptoms are extremely dangerous, so if they occur, you should immediately consult a doctor.

At-risk groups

Peripheral chorioretinal dystrophy of the retina most often affects people with high degree myopia. This is due to the fact that with myopia, the eyeball grows in length. Consequently, this leads to severe stretching and thinning of the retina. As a result, it becomes extremely susceptible to degenerative processes.

The risk group also includes persons over 65 years of age and patients diabetes mellitus, atherosclerosis, hypertension. In all these people, the retina of the eye for various reasons suffers from a lack of oxygen and nutrients. All this is a powerful impetus to the development of dystrophy.

Which doctor deals with the treatment of peripheral retinal dystrophy

Retinal PCRD is treated by a retinologist. He specializes in the diagnosis and treatment of diseases of the posterior segment of the eyeball (vitreous, reticular and choroid).

In the event of complications, the patient may need the help of an ophthalmic surgeon or laser ophthalmologist. These specialists perform complex surgeries to heal retinal tears and detachments. In difficult situations, their help allows you to preserve and even restore partially lost vision.

Diagnostics

Methods used to diagnose peripheral degenerations.

Visiometry	The patient is seated at a certain distance from the Sivtsev chart and asked to read the letters in different rows. If he is experiencing difficulties, his vision is checked with correction (lenses of different strengths).	The method allows you to identify myopia or other visual impairments. An uncorrected decrease in visual acuity indicates damage to the retina.
Perimetry	The patient's visual fields are checked. Instead of perimetry, campimetry or an Amsler grid can be used.	The examination reveals a narrowing of the visual fields or the appearance of cattle. The location of defects gives an idea of \u200b\u200bthe localization of foci of degeneration.
Ophthalmoscopy	Having previously dilated the pupil, the doctor examines the fundus. For this purpose, he can use a direct or indirect ophthalmoscope. If it is necessary to examine the distant parts of the retina, he uses a Goldman three-mirror lens.	With ophthalmoscopy, an experienced ophthalmologist can see pathological changes in the retina. Since all dystrophies look different, they can be distinguished visually.
Sclerocompression	The manipulation is performed during ophthalmoscopy. The doctor gently presses the sclera, trying to move the retina closer to the center.	Sclerocompression makes it possible to examine the most distant areas of the fundus.
Instrumental methods	To clarify the diagnosis, the patient can undergo optical coherence tomography or electrophysiological studies.	Modern techniques make it possible to get a clear idea of \u200b\u200bthe state of the retina and the location of degenerative foci.

To date, there are no methods that can completely cure peripheral vitreochorioretinal dystrophy of the retina. It is possible to suspend the development of the disease with the help of medication, physiotherapy, laser and surgical treatment. The correct approach to dealing with the disease allows you to preserve vision and avoid dangerous complications. More about eye surgery →

Drugs that help slow the progression of dystrophy:

• Antiplatelet agents ( Acetylsalicylic acid, Ticlopidine, Clopidogrel). Useful for hypertension and cardiovascular diseases. They thin the blood and inhibit thrombus formation, thereby protecting the retina from hypoxia.
• Vasodilators and angioprotectors (Actovegin, Vinpocetine, Pentoxifylline). They relieve spasm of retinal vessels and protect the vascular walls from damage. Improves blood circulation in the retina, preventing its destruction.
• Vitamin and mineral complexes (Ocuwaite-Lutein, Bilberry-Forte). Saturate the mesh nutrients, vitamins and minerals. Slow down the course of degenerative processes. Read more about vitamins for eyes →
• Biological regulators (Retinolamine). Restores the permeability of retinal vessels and normalizes the work of photoreceptors. They stimulate reparative processes, that is, they accelerate the restoration of the retina.

Strengthen the retina and prevent detachment by using laser treatment... During the procedure, the specialist solders the mesh to the vascular membrane, which is located under it. This allows you to limit the foci of degeneration.

Prevention

There is no specific prophylaxis of the disease today. You can reduce the risk of developing dystrophy with the help of gymnastics for the eyes and proper nutrition. Biologically very useful in this regard active additivescontaining zinc, vitamins E, A, group B. Protection of the eyes from ultraviolet radiation with sunglasses also helps to avoid illness.

Peripheral retinal dystrophies often develop in the elderly and in persons with high myopia. The reason for this is the stretching of the retina or impaired blood circulation and metabolism in it.

To combat degenerations, medicinal, physiotherapy, laser and surgical techniques are used. Laser coagulation of the retina is today considered the most effective method of treating pathology. With its help, you can limit dystrophic foci and prevent the spread of the pathological process.

Useful video about peripheral retinal dystrophy

okulist.pro

Peripheral retinal dystrophy is one of the rare, but quite dangerous diseases. When an ailment appears, the lack of timely medical care can lead to disastrous consequences, but proper treatment will help preserve vision. In addition, the problem can be difficult to diagnose and usually takes a long time to analyze.

Definition of disease

Peripheral retinal dystrophy is usually understood as an eye disease (most often of a hereditary nature), the development of which is accompanied by tissue destruction processes with subsequent deterioration of vision. In advanced stages, complete loss of vision is likely without the possibility of recovery.

According to official statistics, up to forty percent of people with farsightedness and up to eight percent suffer from myopia.

People with diseases of the organs of vision are recommended prevention and periodic examination for the possibility of acquiring retinal dystrophy.

The following forms of the disease are distinguished:

• Lattice... It is characterized by the appearance of white streaks, deterioration of blood circulation in the blood vessels of the eye and the formation of cysts. Often occurs against the background of retinal detachment.
• Retinoschisis... It is characterized by retinal stratification, most often observed with the development of myopia. In most cases, it is hereditary.
• Frostlike... It is characterized by the appearance of frost-like white inclusions on the anterior surface of the eye. It is inherited.
• With changes in the form of a snail trail. When a disease occurs, the appearance of perforated pathologies resembling a snail track is observed. Often accompanied by tissue tears.
• With altered cobblestone pavement... With the disease, pathologies are observed in the form of oblong rings, it is possible to separate pieces of pigment. Often diagnosed with myopia.
• Small cystic... It is characterized by the appearance of a large number of small red cysts.

Causes of occurrence

The disease can occur in people of any age and category. Among the most common causes of its occurrence are:

• Inflammation of the organs of vision;
• Heredity (if relatives suffered from this type of problem);
• Traumatic brain injury, eye damage;
• Farsightedness (less often - myopia);
• Injuries associated with excessive physical exertion;
• Diabetes;
• Atherosclerosis;
• Cardiovascular diseases;
• Chronic diseases;
• Diabetes;
• Violation of the blood supply to the organs of vision;
• Intoxication of the body.

Accumulated waste products in the body can also cause the problem. Rarely, the disease develops during pregnancy.

Symptoms

In the early stages of the disease, most often there are no signs of its development. Most of the symptoms (with the exception of those visible) are the same for each type of retinal dystrophy:

• Deterioration of visual acuity (not always symmetrical);
• Veil, fog before the eyes;
• Wrong perception of colors;
• Wrong perception of the forms of objects of the surrounding reality;
• Rapid fatigue, constant eye fatigue.

Sometimes symptoms can occur simultaneously, or they can occur separately or in turn.

In the event of abnormal fatigue of the organs of vision, it is recommended to contact an ophthalmologist for diagnostics for the development of retinal dystrophy.

Possible complications

In the case of a timely diagnosis of the disease, its progression is stopped with the help of treatment. The quality of the results of the intervention depends on the stage of development of dystrophy. In the absence of proper treatment, destruction of important tissues of the eye, complete or partial loss of vision without the possibility of recovery is possible. Retinal detachment is also possible.

Currently, there are several methods for treating peripheral retinal dystrophy. Their choice depends on the type and stage of the problem.

Medication

Treatment of the disease with medications gives positive results only in the early stages and in the case of a combination with other methods. Among the main drugs for procedures are:

• Vasoconstrictor;
• Medicines containing lutein;
• Angioprotectors;
• Means for strengthening blood vessels;
• Vitamin complexes.

Surgically

Typically, surgery is indicated to improve blood flow and metabolism. However, the following procedures are most often carried out:

• Physiotherapy... The therapy strengthens the muscles and the retina of the eye.
• Laser coagulation... It is performed to prevent retinal detachment. During the operation, the damaged areas are cauterized.

It should be noted that these techniques will not be able to restore lost vision, but will stop the development of the disease.

Folk remedies

Traditional methods will help prevent the irreversible consequences of the course of peripheral dystrophy and improve the condition of the organs of vision in general. However, it is recommended to use them only after consulting an ophthalmologist and as an adjunct to medical methods.

An infusion of Japanese sophora is used as such an additional agent. Five grams of Sophora are mixed with half a liter of vodka and infused for three months. Apply the product one teaspoon three times a day, after mixing with a little water.

Prevention

The main preventive method for peripheral retinal dystrophy is periodic examination by an ophthalmologist. For those who have vision problems and frequent diseases of the organs of vision, constant observation by a doctor is especially important. In addition, a healthy lifestyle, immune support and the adoption of vitamin complexes are beneficial.

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findings

Peripheral retinal dystrophy is a rare disease that is dangerous to health and vision. It is difficult to diagnose and does not always respond to full recovery. However, its development can be easily prevented by seeking medical help when the first symptoms appear, and its development can be stopped, thereby increasing the chances of maintaining vision.

Retinal dystrophy is one of the most serious eye pathologies that can lead to blindness. The reason for this process is violations in vascular system eye. The peripheral zone of the retina is hidden behind the eyeball, which makes it invisible when examining the fundus.

To determine peripheral vitreochorioretinal dystrophy (PVCRD), a special study is required. The possibility of blindness, mild symptoms and the need for special diagnostics make the retinal PWRD very dangerous and insidious disease.

The disease does not have symptoms that characterize this type of pathology exhaustively. In case of PVCRD, the following are observed:

• loss of visual acuity;
• pop-up spots, flies, blots in front of both eyes.

Patients have different characteristics for the interference that appears and obscures the field of vision. The presence of such problems requires contacting an optometrist.

Causes

Retinal dystrophy is provoked by vascular disorders of the eye and a lack of blood supply. Degeneration can be pushed by:

• eye injuries and craniocerebral;
• different forms of diabetes;
• infectious diseases;
• myopia;
• inflammatory eye diseases.

Pathological changes can occur in both eyes at the same time or affect only the left or right eye.

Retinal PVCRD can affect only one eye or develop in two at once.

There are many reasons for the development of peripheral vitreochorioretinal dystrophy of the retina. Their action is based on the deterioration of blood circulation in the vessels of the retina, which subsequently changes the biochemical processes occurring in it, as well as in the nearby parts of the vitreous body. As a result of these violations, adhesion of the retina and the vitreal body occurs. Such processes can occur in persons with emmetropic visual acuity.

With myopia, the anteroposterior size of the eyeball increases, as a result of which stretching of the eye structures is observed. The retina becomes thinner, angiopathy develops, the blood supply is disturbed, the peripheral parts are especially affected, and in the presence of vitreoretinal moorings, rupture is possible.

Inadequate blood supply causes dystrophic thinning of the retinal layer, which can lead to rupture and loss of vision. Ruptures occur from excessive physical exertion, lifting weights, climbing to a height or descending under water in places of the greatest dystrophic tissue changes.

Myopia is a serious provoking factor in the development of retinal degeneration. Myopia leads to a stretching of the eyeball. This leads to a change in the entire structure of the visual organ - the periphery of the retina becomes thinner, blood flow worsens.

High myopia should be the reason for regular visits to the ophthalmologist in order to timely diagnose peripheral vitreochorioretinal dystrophy of the retina.

However, most ophthalmologists consider heredity to be the main factor in the development of PVCRD. Eye pathologies are often familial and are transmitted from parents to children.

Heredity is one of the factors provoking the RVF.

The meaning of the difference between PCRD and PVCRD

Both types of pathology - chorioretinal and vitreochorioretinal - are associated with vascular disorders of the eyes, which lead to the development of retinal degeneration.

Peripheral vitreochorioretinal dystrophy is more dangerous species diseases, because degenerative changes also affect the vitreous body of the eye. Vitreo - vitreo agg - from Latin glass, vitreous.

The second type of disease - PRHD - affects only the retina itself and blood vessels.

The first type of disease is less common, but requires increased attention from the doctor and the patient, because it threatens with retinal detachment and loss of vision. Vitreoretinal adhesions of the vitreous body to the retina provoke destruction of its layer and rupture.

Do not confuse PVCRD and PCRD - these are two different pathologies.

Classification (types and types of retinal rupture)

Along the course, peripheral vitreochorioretinal dystrophy is:

1. 1. With a benign course:
      • Cobblestone degeneration is a white area of \u200b\u200batrophy. With her, through the affected retina, the vessels of the choroid are seen against the background of the sclera. The cause of development is occlusion of the vessels of the choroid, which leads to postischemic atrophy pigment epithelium and the outer layers of the retina. It is found in the lower half of the fundus between the dentate line and the equator. Not complicated by tears or detachment.
      • Equatorial Druze. Pale formations of small size, may have pigmentation along the contour. They are located along the jagged line.
      • Pigmented oroparallel degeneration. Age change, manifested by increased pigmentation along the "jagged" line.
      • Cellular degeneration. Appears in the elderly. It is represented by perivascular pigmentation, can reach the equator.
   2. With a poor-quality course:

1. 1. • "Lattice" dystrophy. The "lattice" in ophthalmoscopy is visible as thin stripes whiteforming a lattice-like shape. Between these stripes, erosion, cysts and micro-tears, zones of hypopigmentation or hyperpigmentation appear, there may even be diffuse pigmentation. The vitreal body above the "lattice" area is liquefied, but along the contour, on the contrary, is compacted and welded to its edges. As a result, vitreochorioretinal moles appear, contributing to the formation of retinal valve ruptures.
      • Dystrophy of the "snail track" type. Pathology develops due to vascular lesions and is manifested by the appearance of whitish inclusions consisting of microglia and astrocytes. With the presence of pin erosion and perforated defects. Degenerative foci can join and form large defects. Has a high risk of detachment.
      • Frost-like degeneration is a hereditary retinal disorder. Retinal manifestations are usually symmetrical and affect both eyes. Ophthalmoscopically manifests itself in the form of large formations of yellowish-white color, similar to "snow flakes". It progresses slowly and does not often lead to complications.

PVCRD is classified by flow and type of rupture.

By the type of retinal rupture, there are the following types:

1. 1. • Hole - a part of the retina is completely torn off due to ZOST. It occurs with lattice dystrophy.
      • Valve - the break is partially covered, a valve is formed. Formed in the presence of vitreoretinal adhesion.
      • By the type of dialysis - the retina is torn along the dentate line. Dialysis develops when the eye is contused.

The stages of the disease indicate the severity, degree and types of ruptures and tractions, and are from I to V. Starting from stage IV, laser coagulation is always indicated. PVCRD 2I degree or stage, for example, does not have absolute readings, and the decision on further treatment is made individually.

PVCRD during pregnancy

According to medical organizations by the beginning of the reproductive period, more than 25% of women have myopia, more than 7% of them have a high degree. Against the background of the normal course of pregnancy in women with myopia, a narrowing of the retinal vessels is noted.

This is due to the increased load on cardiovascular system and the need for additional circulation for the unborn child. Therefore, during pregnancy, patients are twice examined by an ophthalmologist with full examination fundus.

In the case of the development of PVCRD during pregnancy, laser coagulation is indicated. It can be done for up to 32 weeks. After a successful operation, a woman can give birth herself.

Necessity caesarean section during pregnancy of a woman with PWRD of the retina, it is found out one month before the estimated date of birth.

The decision on the need for a cesarean section due to degenerative conditions of the retina is made one month before delivery. A high degree of myopia (more than 6.0 diopters) is not an indication for surgery.

Diagnostics

The initial stage of peripheral vitreochorioretinal degeneration proceeds without symptoms, weakening of vision and the appearance of obstructions in front of the eyes begins with the destruction of the layer. During a routine examination of the fundus, the peripheral areas are hidden by the eyeball.

Patients with a high degree of myopia are more likely to be examined by an ophthalmologist, since they belong to the risk group. PVCRD is often detected in many patients when the detachment process has already begun. Therefore, for weak and medium myopia with an obvious and constant deterioration in visual acuity should be diagnosed.

To diagnose the disease, the following are carried out:

1. 1. • examination of the fundus with a Goldman lens using medications that dilate the pupil;
      • determination of visual fields;
      • Ultrasound, optical tomography and electrophysiological examination;
      • sclerocompression.

With the help of modern digital devices, it is possible to obtain a color image of the peripheral part of the retina and assess the degree and area of \u200b\u200bthe lesion.

Examination of the fundus with a Goldman lens helps to diagnose PWHM.

Ophthalmologic examination includes diagnostics of the PWHM before conscription. Depending on the degree and nature of the disease, a delay is given for laser coagulation.

Treatment

Retinal degeneration is an irreversible process; it will not be possible to return the tissue to normal. Treatment is aimed at slowing down the deterioration and improving vision.

Medicinal methods

With a PVCRD on initial stage are used conservative methods treatment - reception drugs... Shown:

1. 1. • Multivitamins and microelements, nourishing tissues, stop degeneration processes. A healthy diet should be followed, giving preference to nuts, fish, vegetables and fruits.
      • Drugs that stop the development of blood clots in blood vessels (Aspirin, Ticlopidine).
      • Vasodilators (No-shpa, Askorutin).
      • Eye dropsimproving metabolism.
      • Eye injections to improve microcirculation.

These agents help stop the process of tissue destruction. Complex administration of drugs is carried out twice a year.

Ascorutin is prescribed as a vasodilator.

Physiotherapy

The procedures help to stop tissue degeneration. Prescribe electrophoresis, electro- or photostimulation of the retina, laser. Treatment is carried out in courses.

Laser procedure

In order to prevent retinal detachment, laser coagulation is used, this is the most efficient methodproven to be effective. The laser beam glues the retina in places of stretching with the vascular fundus of the optic organ, preventing detachment.

Barrier laser coagulation (BLK) is performed under local anesthesia, the procedure lasts 10-20 minutes. The patient is allowed to go home immediately after the manipulation. IN modern medicine this is best remedy, preventing the severe consequences of PVCRD and angiopathy.

Surgery

Operations for peripheral vitreochorioretinal dystrophy are performed in severe cases, when drug treatment, nor laser coagulation give an effect.

The operation is performed only if other methods of treatment fail.

Prevention

When a disease is detected, prevention is aimed at preventing further development pathological process and prevention of retinal rupture.
Patients with PVCRD should remember - only respect to health, strict adherence to preventive measures and doctor's prescriptions will help to avoid terrible complications.

Must be avoided physical activity, lead a healthy lifestyle, visit an ophthalmologist twice a year and carry out treatment courses.

People who fall into risk groups should be careful and undergo medical examination on time. You need to give up your excessive passion for the computer, do gymnastics for the eyes, take vitamins.

Proper nutrition, refusal bad habits will help to minimize the risk of hereditary factors of the disease and to avoid PFRD.

Nov 28, 2017 Anastasia Tabalina

It is on the periphery of the retina that degenerative processes often develop.

Peripheral retinal dystrophies - an invisible danger

The peripheral area of \u200b\u200bthe retina is practically invisible during the usual standard examination of the fundus. But it is on the periphery of the retina that dystrophic (degenerative) processes often develop, which are dangerous in that they can lead to tears and retinal detachment.

Changes in the periphery of the fundus - peripheral retinal dystrophies - can occur in both myopic and hyperopic people, as well as in people with normal vision.

Possible Causes of Peripheral Retinal Dystrophy

The causes of peripheral retinal dystrophic changes are not fully understood. The onset of dystrophy is possible at any age, with the same probability in men and women.

There are many possible predisposing factors: hereditary, myopia of any degree, inflammatory eye diseases, craniocerebral and visual organ injuries. General diseases: hypertension, atherosclerosis, diabetes, intoxication, past infections.

The leading role in the onset of the disease is played by the violation of the blood supply to the peripheral retina. Deterioration of blood flow leads to metabolic disorders in the retina and to the appearance of local functionally altered areas in which the retina is thinned. Under the influence of physical exertion, work associated with lifting to a height or immersion under water, acceleration, transfer of weights, vibration, tears may occur in dystrophic areas.

However, it has been proven that in people with myopia, peripheral degenerative changes in the retina are much more common, because with myopia, the length of the eye increases, resulting in stretching of its membranes and thinning of the retina at the periphery.

PRHD and PVCRD - what's the difference?

Peripheral retinal dystrophies are divided into peripheral chorioretinal dystrophies (PCRD), when only the retina and choroid are affected, and peripheral vitreochorioretinal dystrophies (VVCD), with involvement of the vitreous body in the degenerative process. There are other classifications of peripheral dystrophies that are used by ophthalmologists, for example, according to the localization of dystrophies or according to the degree of danger of retinal detachment.

Some types of peripheral retinal dystrophy

Lattice dystrophy - most often detected in patients with retinal detachment. A familial hereditary predisposition to this kind dystrophy with a higher frequency in men. Typically found in both eyes. It is most often localized in the upper-outer quadrant of the fundus equatorially or anteriorly to the equator of the eye.

On examination of the fundus, lattice degeneration appears as a series of narrow white fleecy stripes that form figures resembling a lattice or rope ladder. This is what obliterated retinal vessels look like.

Between these altered vessels, there are pinkish-red foci of retinal thinning, cysts and retinal tears. Characteristic changes in pigmentation in the form of darker or lighter spots, pigmentation along the vessels. The vitreous body is, as it were, fixed to the edges of dystrophy, i.e. "tractions" are formed - cords pulling the retina and easily leading to ruptures.

Dystrophy of the "snail track" type. On the retina, whitish, slightly gleaming, streak-like inclusions with many small thinning and perforated defects are found. Degenerative foci merge and form ribbon-like zones, which appearance resemble a snail track. Most often located in the upper-outer quadrant. As a result of such dystrophy, large, round-shaped tears can form.

Frost-like dystrophy is hereditary disease the periphery of the retina. Fundus changes are usually bilateral and symmetrical. On the periphery of the retina there are large yellowish-white inclusions in the form of "snow flakes" that protrude above the surface of the retina and are usually located at thickened partially obliterated vessels, there may be pigment spots.

Frost-like degeneration progresses over a long time and does not lead to ruptures as often as ethmoid and snail trail.

Cobblestone degeneration is usually located far in the periphery. Individual white foci, slightly elongated, are visible, around which small lumps of pigment are sometimes determined. It is more often found in the lower parts of the fundus, although it can be determined along the entire perimeter.

Cystic (small cystic) retinal dystrophy is located at the extreme periphery of the fundus. Small cysts can coalesce to form larger ones. In case of falls, blunt trauma, rupture of cysts is possible, which can lead to the formation of perforated ruptures. On examination of the eye day, the cysts appear as multiple round or oval bright red formations.

Retinoschisis - retinal detachment - can be congenital and acquired. More often it is a hereditary pathology - a malformation of the retina. Congenital forms of retinoschisis include congenital retinal cysts, X-chromosomal juvenile retinoschisis, when in patients, in addition to peripheral changes, dystrophic processes are often found in the central zone of the retina, leading to decreased vision. Acquired dystrophic retinoschisis most often occurs with myopia, as well as in old and senile age.

If there are also changes in the vitreous body, then often traction (cords, adhesions) are formed between the changed vitreous body and the retina. These adhesions, joining at one end to the thinned area of \u200b\u200bthe retina, greatly increase the risk of tears and subsequent retinal detachment.

Retinal tears

By type, retinal breaks are subdivided into perforated, valvular, and by the type of dialysis.
Hole tears most often result from lattice and racemose dystrophy, a hole in the retina gaping.

A valvular rupture is when a portion of the retina covers the rupture site. Valve ruptures are usually the result of vitreoretinal traction, which pulls the retina with it. When a rupture is formed, the area of \u200b\u200bvitreoretinal traction will be the apex of the valve.

Dialysis is a linear tear of the retina along the dentate line - the place where the retina attaches to the choroid. In most cases, dialysis is associated with blunt trauma to the eye.

The gap in the fundus looks like bright red clearly outlined foci of various shapes, through which a pattern is visible choroid... Retinal tears are especially noticeable against a gray background of detachment.

Diagnosis of peripheral dystrophy and retinal tears

Peripheral retinal dystrophies are dangerous because they are practically asymptomatic. Most often they are found by accident during examination. In the presence of risk factors, detection of dystrophy may be the result of a careful targeted examination. There may be complaints about the appearance of lightning, flashes, the sudden appearance of more or less floating flies, which may already indicate a retinal tear.

A complete diagnosis of peripheral dystrophy and "silent" breaks (without retinal detachment) is possible when examining the fundus under conditions of maximum drug-induced expansion of the pupil using a special Goldman three-mirror lens, which allows you to see the most extreme areas of the retina.

If necessary, scleral pressure (sclerocompression) is used - the doctor kind of pushes the retina from the periphery to the center, as a result of which some peripheral areas inaccessible for inspection become visible.

Today there are also special digital devices, with the help of which it is possible to obtain a color image of the periphery of the retina and, in the presence of zones of degeneration and ruptures, to estimate their size relative to the area of \u200b\u200bthe entire fundus.

Treatment of peripheral dystrophy and retinal tears

If peripheral dystrophy and retinal ruptures are detected, treatment is carried out to prevent retinal detachment.

Prophylactic laser coagulation of the retina in the area of \u200b\u200bdystrophic changes or delimiting laser coagulation around an existing gap is performed. With the help of a special laser, the retina is influenced along the edge of the dystrophic focus or rupture, as a result of which the retina is "glued" with the underlying membranes of the eye at the points of exposure to laser radiation.

Laser coagulation is performed on an outpatient basis and is well tolerated by patients. It must be borne in mind that the process of adhesion formation takes some time, therefore, after laser coagulation it is recommended to observe a sparing regimen that excludes heavy physical labor, climbing to a height, diving under water, activities associated with acceleration, vibration and sudden movements (running, parachuting, aerobics, etc.).

Prevention

Speaking of prevention, first of all, they mean the prevention of retinal tears and detachment. The main way to prevent these complications is the timely diagnosis of peripheral retinal dystrophy in risk group patients, followed by regular monitoring and, if necessary, preventive laser coagulation.

The prevention of formidable complications entirely depends on the discipline of patients and attention to their own health.

Patients with existing retinal pathology and patients at risk should be examined 1 to 2 times a year. During pregnancy, it is necessary to examine the fundus at least twice for wide pupil - at the beginning and at the end of pregnancy. An ophthalmologist's examination is also recommended after childbirth.

Prevention of the dystrophic processes themselves on the periphery of the retina is possible in representatives of the risk group - these are myopic, patients with a hereditary predisposition, children born as a result of a severe course of pregnancy and childbirth, patients with arterial hypertension, diabetes mellitus, vasculitis and other diseases in which there is a deterioration in peripheral circulation.